随机、安慰剂对照、双盲临床试验,研究维生素D在控制心血管危险因素、抑郁症状和自杀风险中的作用

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Catarina Porto , Katia Petribu , Nathalia Barbosa , Rayana Magalhães , Cecília Lira , Ana Beatriz Porto , Brivaldo Markman-Filho , Andrea Lordsleem , Eveline Calado , José Magalhães , Everton Sougey , Tatiana Silva , Aluísio Junio , Francisco Bandeira , Rita Leão
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引用次数: 0

摘要

目的评价补充维生素D对控制心血管危险因素和治疗抑郁症状(包括自杀风险)的作用。方法采用随机、安慰剂对照、双盲的临床试验方法,从巴西东北部两所大学的精神科门诊招募224名确诊为重度抑郁症的成年人(18-61岁)。参与者随机接受维生素D补充(50,000 IU/周;n = 112)或安慰剂(n = 112)六个月。评估包括抑郁症状、自杀风险、临床/实验室心血管参数和基线和180天的血清维生素D。统计分析采用卡方或Fisher精确检验、McNemar检验、学生t检验或Mann-Whitney检验,比值比(or)和95%置信区间(CI)。显著性水平设为5%。结果补充维生素D可显著提高血清浓度至适当的生理水平,显著降低抑郁症状(p = 0.001)和自杀风险(p = 0.001)。此外,15个评估的心血管危险因素中有13个显示正常化或显着降低,没有与钙代谢相关的不良事件或其他副作用。改善包括更好的血脂、血糖控制和炎症标志物。在临床上,这些发现表明维生素D可能作为抑郁症治疗的辅助疗法,有助于精神健康和心脏代谢稳定。优点和局限性优点包括严格的双盲、随机设计、概率抽样和全面的临床-实验室评估。局限性包括单一地区的样本,补充后缺乏长期随访,以及排除有严重合并症的患者,这可能限制了通用性。结论:每周给予50,000 IU维生素D,持续6个月,可有效减少抑郁症状和自杀风险,同时改善心血管健康指标,突显其作为精神科和初级保健机构可获得的低成本辅助治疗的前景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Randomized, placebo-controlled, double-blind clinical trial on the contributions of vitamin D in the control of cardiovascular risk factors, depressive symptoms and suicide risk

Objectives

To evaluate the contributions of vitamin D supplementation to the control of cardiovascular risk factors and the treatment of depressive symptoms, including suicide risk.

Methods

A randomized, placebo-controlled, double-blind clinical trial was conducted with 224 adults (18–61 years) diagnosed with major depressive disorder, recruited from psychiatric clinics of two universities in Northeast Brazil. Participants were randomized to receive vitamin D supplementation (50,000 IU/week; n = 112) or placebo (n = 112) for six months. Assessments included depressive symptoms, suicide risk, clinical/laboratory cardiovascular parameters, and serum vitamin D at baseline and day 180. Statistical analysis used chi-squared or Fisher's exact test, McNemar's test, Student's t-test or Mann-Whitney test, with odds ratios (OR) and 95 % confidence intervals (CI). Significance level was set at 5 %.

Results

Vitamin D supplementation significantly increased serum concentrations to adequate physiological levels and led to marked reductions in depressive symptoms (p = 0.001) and suicide risk (p = 0.001). Additionally, 13 of 15 evaluated cardiovascular risk factors showed normalization or significant reduction, without adverse events related to calcium metabolism or other side effects. Improvements included better lipid profile, glycemic control, and inflammatory markers. Clinically, these findings suggest potential for vitamin D as an adjuvant therapy in depression management, contributing to both mental health and cardiometabolic stability.

Strengths and limitations

Strengths include the rigorous double-blind, randomized design, probabilistic sampling, and comprehensive clinical-laboratory evaluation. Limitations involve the single-region sample, lack of long-term follow-up after supplementation, and the exclusion of patients with severe comorbidities, which may limit generalizability.

Conclusion

Weekly administration of 50,000 IU of vitamin D for six months proved effective in reducing depressive symptoms and suicide risk while improving cardiovascular health markers, highlighting its promise as an accessible, low-cost adjunctive therapy in psychiatric and primary care settings.
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CiteScore
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